Huang Q, Wendler O, Langer F, Tscholl D, Schaefers H J
Department of Thoracic and Cardiovascular Surgery, Tongji Hospital, Tongji Medical University, Wuhan 4300300.
J Tongji Med Univ. 2000;20(4):308-10. doi: 10.1007/BF02888187.
The free flow of skeletonized ITA grafts was compared with that of pedicled ITA grafts. One hundred patients with coronary artery diseases underwent elective CABG. In the group I (n = 50), the left ITA was dissected using the skeletonization technique. In the group II (n = 50), the ITA was harvested as a pedicled graft. Free flow of the ITA was recorded before and 15 min after intraluminal application of diluted papaverine. Mean arterial pressure was maintained at 9.31 kPa (70 mmHg). The results showed that before the application of papaverine, free flow of skeletonized and pedicled ITA grafts was identical between the two groups. After treatment with papaverine, the maximum free flow was significantly higher in the skeletonized ITA's in the group I (199.3 +/- 69.6 ml/min) than in the group II (145.7 +/- 70.3 ml/min, P < 0.05). There was on significant difference between the free flow after dilatation of the left and right ITA in the group I (left 199.3 +/- 69.6 ml/min, right 198.9 +/- 61.8 ml/min, respectively). It was concluded that preparation of the ITA with the skeletonization technique resulted in significantly higher free flow capacity than in pedicled grafts and would improve the results of arterial revascularization. The complication rate seems to be lower than with the conventional method.
将骨骼化胸廓内动脉（ITA）移植物的血流情况与带蒂ITA移植物的血流情况进行了比较。100例冠心病患者接受了择期冠状动脉旁路移植术（CABG）。在第一组（n = 50）中，采用骨骼化技术解剖左ITA。在第二组（n = 50）中，将ITA作为带蒂移植物获取。在腔内应用稀释的罂粟碱之前和之后15分钟记录ITA的血流情况。平均动脉压维持在9.31 kPa（70 mmHg）。结果显示，在应用罂粟碱之前，两组中骨骼化和带蒂ITA移植物的血流情况相同。用罂粟碱治疗后，第一组中骨骼化ITA的最大血流（199.3±69.6 ml/min）显著高于第二组（145.7±70.3 ml/min，P < 0.05）。第一组中左、右ITA扩张后的血流之间无显著差异（左分别为199.3±69.6 ml/min，右为198.9±61.8 ml/min）。得出的结论是，采用骨骼化技术制备ITA导致其血流容量显著高于带蒂移植物，并将改善动脉血运重建的效果。并发症发生率似乎低于传统方法。
